He Ting, Zhu Wenying, Jiang Yuanming, Chen Pei, Cai Qian
Department of Otolaryngology Head and Neck Surgery,First Hospital of Wuhan,Wuhan,430001,China.
Department of Otolaryngology Head and Neck Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Mar;35(3):238-241. doi: 10.13201/j.issn.2096-7993.2021.03.010.
To investigate the risk factors affecting the surgical outcome of severe tracheal stenosis. The data of 36 patients with severe tracheal stenosis were analyzed retrospectively. All patients underwent tracheal stenosis resection with primary end-to-end anastomosis.Six factors including the location of tracheal stenosis, the length of resected trachea, the degree of stenosis, scar constitution, diabetes and gastroesophageal reflux disease were analyzed by univariate analysis and multivariate Logistic regression analysis. Finally, 23 cases were extubated,including 19 cases with successful extubation and 4 cases with granulation tissue removed by bracing laryngoscope.Univariate analysis showed that the location of tracheal stenosis, the length of resected trachea,scar constitution, diabetes and gastroesophageal reflux disease were the risk factors affecting the surgical efficacy of severe tracheal stenosis.The multivariate Logistic regression coefficients of each factor were 2.857, 1.761, 3.123, -1.066, 3.545 respectively. Conclution: The risk factors affecting the outcome of severe tracheal decannulation rate were the location of tracheal stenosis, the length of resected trachea, scar constitution, diabetes and gastroesophageal reflux disease. Among them, the stenosis position, the length of the resected trachea, scar constitution and gastroesophageal reflux disease had more significant effects on the prognosis of the operation, and the comprehensive evaluation of these risk factors before operation was conducive to improve the surgical effect.
探讨影响重度气管狭窄手术疗效的危险因素。回顾性分析36例重度气管狭窄患者的资料。所有患者均行气管狭窄切除并一期端端吻合术。对气管狭窄部位、切除气管长度、狭窄程度、瘢痕体质、糖尿病和胃食管反流病6项因素进行单因素分析及多因素Logistic回归分析。最终,23例患者拔管,其中19例拔管成功,4例经支撑喉镜清除肉芽组织。单因素分析显示,气管狭窄部位、切除气管长度、瘢痕体质、糖尿病和胃食管反流病是影响重度气管狭窄手术疗效的危险因素。各因素的多因素Logistic回归系数分别为2.857、1.761、3.123、-1.066、3.545。结论:影响重度气管拔管率的危险因素为气管狭窄部位、切除气管长度、瘢痕体质、糖尿病和胃食管反流病。其中,狭窄部位、切除气管长度、瘢痕体质和胃食管反流病对手术预后影响更为显著,术前对这些危险因素进行综合评估有利于提高手术效果。